AREA MAN STAYS AWAKE FOR SCALP SURGERY.Byline: Krystn Shrieve Staff Writer VENTURA - Eugene Kernan, 73, needed a process similar to a skin graft skin graft Autologous, donated, or surrogate skin removed from one site to cover surfaces on another region with 3rd-degree burns or traumatic tissue loss. See Split-thickness graft. Cf Artificial skin, 'Spray-on' skin. when skin cancer led to a long-term scalp lesion that wouldn't heal. The problem was causing a deterioration of the Ventura resident's skin and skull, but surgery using general anesthesia Anesthesia, General Definition General anesthesia is the induction of a state of unconsciousness with the absence of pain sensation over the entire body, through the administration of anesthetic drugs. was too risky because Kernan suffers from emphysema emphysema (ĕmfĭsē`mə), pathological or physiological enlargement or overdistention of the air sacs of the lungs. A major cause of pulmonary insufficiency in chronic cigarette smokers, emphysema is a progressive disease that commonly . So Dr. William Shaw tried something new. He did the surgery without general anesthesia and used two other pain relief methods. ``We came up with a customized solution,'' said Shaw, chief of plastic surgery at the University of Calfornia, Los Angeles, Medical Center. A flap of skin was removed from Kernan's right thigh and attached to his head. Shaw gave Kernan a spinal epidural epidural /epi·du·ral/ (-dur´il) situated upon or outside the dura mater. ep·i·du·ral adj. Located on or over the dura mater. n. - often used during difficult child births - to numb him from the waist down. Then he gave him local anesthesia Anesthesia, Local Definition Local or regional anesthesia involves the injection or application of an anesthetic drug to a specific area of the body, as opposed to the entire body and brain as occurs during general anesthesia. on his head, an approach often used when doing face lifts. He hopes this same procedure can be used on other patients who are at high risk from general anesthesia. ``In this case, I thought that if I could use the same technique used in face lifts - and if he's cooperative and not afraid - then it would work,'' Shaw said. ``This was the only chance we had, but I knew we couldn't run into any problems. ``It was like a war,'' Shaw said. ``We created junctions and knew that, if we checked out well at each of them, we could move ahead. If we didn't, we would abandon the idea. Luckily for him it worked out well, and we were able to make the transplant.'' Kernan was awake during the nine-hour procedure. More complicated than a skin graft, the procedure involved relocating the skin and fatty tissues and reattaching individual blood vessels Blood vessels Tubular channels for blood transport, of which there are three principal types: arteries, capillaries, and veins. Only the larger arteries and veins in the body bear distinct names. . It is commonly used in breast reconstruction Breast Reconstruction Definition Breast reconstruction is a series of surgical procedures performed to recreate a breast. Reconstructions are commonly done after one or both breasts are removed as a treatment for breast cancer. but is rarely done on the skull. ``I'm pretty stoic,'' Kernan said. ``Surgery has never bothered me. At one point I started feeling the staples in my head, but the doctor just gave me another local and I was fine. I have a really high threshold for pain.'' Kernan said he had tried everything to heal the sore on his head that was about the size of a pencil eraser. He tried topical creams and ointments and even spent time in a hyperbaric chamber hyperbaric chamber or decompression chamber or recompression chamber Sealed chamber supplying a high-pressure atmosphere primarily for medical therapy. Breathing air or oxygen at typically 1. for 45 hours of oxygen treatments. ``I thought for sure that it would work but it didn't,'' he said. ``I was grateful that I got a recommendation to go to UCLA UCLA University of California at Los Angeles UCLA University Center for Learning Assistance (Illinois State University) UCLA University of Carrollton, TX and Lower Addison, TX , and I was willing to try anything.'' Shaw said he believes that modifying procedure to fit the patient is key. ``There's no question that medicine has to advance forward. It wouldn't have been right to deny Mr. Kernan a chance,'' he said. ``So rather than telling him there's no hope whatsoever, we had to utilize our resources and technology and provide some sort of solution.' CAPTION(S): photo Photo: Visited by his wife, Eugene Kernan, 73, relaxes after surgery in which he stayed awake for a transplant of skin from his right thigh to his head. |
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